Tag Archives: ST-elevation myocardial infarction (STEMI)

Introduction Dr Pitt O Lim, Consultant Cardiologist The use of drug-coated balloon (DCB) in de novo coronary artery disease has seeped through into routine practice in recent years.1 Largely unnoticed by the mainstream community, ignored by multi-national device companies and rarely discussed at international meetings. Its development actually parallels that of first-generation drug-eluting stent (DES) from the early 2000s; pioneered, propagated and instructed by expert German operators.2,3 Its efficacy is proven for in-stent re-stenosis (ISR),4 small vessel disease,5,6 high-risk bleeder,7 and where stenting might be avoided, such as in Takay

Introduction Ferritin is an essential protein in iron metabolism that reflects body iron homeostasis and is considered a biomarker for inflammation. The clinical significance of serum ferritin levels resides in its strong correlation with adverse outcomes in the general population and patients with various pathological conditions. In this regard, both low and high ferritin values were associated with all-cause mortality in some general population studies.1 Regarding cardiovascular morbidity and mortality, different studies showed that a high serum ferritin level is associated with a higher rate of all-cause and cardiovascular mortality.2,3 Be

Introduction Delays in treatment following ST-elevation myocardial infarction (STEMI) influence patient outcomes. During the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) pandemic, delays in treatment may have altered outcomes of STEMI patients, even in those not infected by COVID-19. On 11 March 2020, the World Health Organisation declared COVID-19 a global pandemic.1 The UK government mandated social distancing on 16 March 2020, and imposed a nationwide lockdown on 23 March 2020.2 Primary percutaneous coronary intervention (PCI) remained our centre’s treatment of choice for STEMI, with thrombolys

Introduction According to the British Heart Foundation (BHF), in the UK there are more than 100,000 hospital admissions each year due to ST-elevation myocardial infarction (STEMI), equating to 280 admissions each day, or one every five minutes.1 The Essex cardiothoracic centre (CTC) is a tertiary, state-of-the-art centre that is equipped to deal with these high-risk cases. There are five district hospitals covered by the Essex CTC to provide a primary percutaneous coronary intervention (PCI) service. The patient turnover is high and there are emergency and elective procedures undertaken every day. The discharge of patients needs to be timely

Introduction Cardiac tamponade and myocardial infarction (MI) are rare as the initial presentation of a malignancy. Lung cancer is among the most common sites from which cardiac metastases arise.1,2 The majority of cases of neoplastic pericardial disease are not detected or diagnosed antemortem due to the usual lack of clinical symptoms.3 Cardiac metastases most commonly occur between ages 50 and 70 years, notably via lymphatic and haematogenous dissemination.4,5 Tumour cells also have the ability to activate the coagulation system causing a prothrombic or hypercoagulable state to develop throughout the course of malignancy.6 Case A 57-year-o

Figure 1. A thrombus aspiration catheter Introduction The use of thrombus aspiration in primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI) has been subject to intense scrutiny and debate over the last decade. Clinical trials have been undertaken, using varying randomisation methodologies, aiming to objectively quantify the impact of the practice, while several subsequent meta-analyses have been conducted with conflicting results. Uncertainty remains and no exclusive guidance has been internationally agreed regarding the definitive usefulness, or otherwise, of the practice. The use of thrombectomy